Cannabis as a Medicine, Part 3

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Section 5. Nineteenth Century Medicine

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During the nineteenth century the hempseed lost its popularity as a medicine in European and American cultures as it once again became favored as an oil-producer. Attention to the use of hemp as a medicine then began to center on the activities of the resin of Cannabis. To traditional M.D.’s and the newly organized alternative medicine doctors, Cannabis resin served as a sedative, a sleep inducer and a pain reliever.[30] One of the earliest European reports of a Cannabis study by physicians is an 1809 article entitled “Intoxicating Preparations made with Cannabis.” But it wasn’t until several decades later when a more acceptable and astute article was published by British physician O’Shaugnessy, then working in the British Colony of India, that Cannabis came to be accepted by all practitioners as a valuable medicine. O’Shaugnessy wrote of the use of Cannabis locally and included the results of some physiological studies in his work.[31] Professional documentation such as this led to American studies and the acceptance by American practitioners of the use of Cannabis indica as a drug.

During the first half of the nineteenth century, new plant drugs were making their way into pharmacy texts. Their period of acceptance was based in large part on the period of their discovery. The popular herbs of the tropics such as Sarsaparilla were first accepted as panaceas (cure-alls), followed by Colonial drugs concocted from American Indian and Aztec remedies, i.e. the Sassafras and American Mandrake of New England and the Cacao and Vanilla of the Aztecs and Peruvians. The most popular early eighteenth century findings were perhaps the alkaloids obtained from Opium, first identified around 1815 by French chemists. Soon to follow were discoveries of other alkaloids, thus focusing doctors’, chemists’ and pharmacists’ interest on the specific toxins in herbal formulas.

By 1850, alkaloid separation became the forte of some pharmaceutical companies such as Abbott Laboratories. Other plant products that could not be isolated like alkaloids were known as resins or resinoids. These became popular herbal drugs for many companies including Lloyd Drugs, Duffield and Davis, and Eli Lilly; many of these companies produced Cannabis indica or Cannabis sativa tinctures and resinoids. Around 1840 two forms of alternative medicine, Eclectic- and Physio-medicine, had evolved their own regimens and training programs. Both had come to accept early on the use of Cannabis as an herbal remedy, in part due to their rebellion against the stronger drugs used by their chief competitors–the allopaths (“traditional M.D.’s”).

The alternatives to traditional or allopathic medicine during the nineteenth century were of several sorts. By the early 1800s, the bloodletting allopaths were in stiff competition with folklore practitioners, herbalists, and graduates of “professional studies” such as Thomsonianism, Physiomedicine, Eclectic Medicine, Homeopathy, Electro-Magnetic Therapy, and Hydrotherapy. Several of these forms of medicine experimented with the use of Cannabis as a medicine. Whereas the traditional doctors (allopaths) relied upon the use of Opiates, Mercurials, and bloodletting, alternative physicians like the Thomsonians relied upon agents which induced vomiting, sweats and vegetable drugs that were not as aggressive as “the mineral drugs.” Originating around 1815, Thomsonian medicine taught its practitioners to administer laxatives and utilize vapor baths, hot cayenne pepper plasters and a select few botanicals. A decade or two later, the Physiomedical doctors became popular, adding to Thomsonianism an extended listing of herbal medicines. In a parallel study of medicine at about the same time, Eclectic doctors came into existence. They were trained herbalists who added concentrated herbal extracts to their regimen, produced by evaporating the solvent from the herbal tea or tincture.

The schools of Eclectic Medicine were fortunate enough to have on their side Finley Ellingwood, M.D. who by the end of the twentieth century was in charge of publishing one of the first professional Eclectic medicine journals–Annuals of Eclectic Medicine and Surgery (volume 1 was published 1890). In it, he writes of the discouraging news about the lack of knowledge on behalf of many practitioners regarding the use of “Cannabis Indica” as a medicine. In 1891 he wrote:[32]

“The full value of this remedy as a therapeutic agent has not been well known. It has been believed to possess greater therapeutic properties than experience has proven it to possess. It is the hashish of India.”

Ellingwood goes on to descibe its benefits as a remedy for “the wakefulness of old age,” nervous exhaustion, melancholy, neuralgia, vertigo, “subacute inflammation of the brain,” delirium tremens (“DT’s”), and “the hypochondria of menopause.” He notes successful use in the treatment of problem cases involving cerebral meningitis, tinnitus, “painful consitions of the womb, ovaries or bladder,” apinful menstrual periods, epilepsy, spasmodic asthma, and the pains experienced in children from teething. Unlike some of today’s uses for Cannabis, Ellingwood felt the use of Cannabis would “allay abnormal sexual appetite.”

A year later, in the following Annual Ellingwood again discussed “Cannabis Indica” repeating many of these applications, adding recommendations for its use in treating chorea, sporadic dysentery, Bright’s disease, chronic heart disease, and gonorrhea. Interestingly, he now adds, in contrast to his earlier writings, a recommendation that Cannabis be used to enhance sexual prowess noting “It increases the tone of the generative organs, overcoming sterility and impotency. For all of these uses, Cannabis was given as a tincture or extract in doses measuring from one-eighth to one grain. Despite these notations, Eliingwood seemed unsure of the success of introducing Cannabis to Eclectic medicine. He editorializes his feelings regarding its use by writing:[33]

“I am convinced that this agent is not used as extensively as it deserves.”

An exemplary Eclectic practitioner of the nineteenth century that made use of Cannabis was Dr. O. Phelps Brown. In his text The Complete Herbalist he provides monographs on the medical uses of herbs, hinting at his familiarity with the euphoriant qualities of Cannabis as he writes in a semi-jovial fashion:[34]

“It is narcotic, anodyne and antispasmodic. It has been successfully employed in gout, neuralgia, rheumatism, locked-jaw, convulsions, chorea, hysteria, and uterine hemorrhage; but it is chiefly valuable as a invigorator of mind and body. Its exhilirating values are unequalled, and it is a certain restorative in low mental conditions, as well as cases of extreme debility and emaciation. In such cases it may be regarded as a real rejuvenator.”

Much later in his text, Brown details the recipes for his patent medicines. One of these medicines, Acacian Balsam, stands out in the local literature for it was used by early Oregon Pioneers. Brown’s formula for Acacian Balsam is: “fluid-extract of Aya-Pana, Indian Hemp plant, Coca, Nicaya, Lungwort, etc., rendered highly aggreeable with Paraguayan Wild Honey.” The Cannabis (“Indian Hemp Plant”) in this formula, along with Coca (Cocaine plant), most certainly must have relieved his patients of all sorts of discomforts. Brown sold his remedy for one dollar per bottle to any willing buyer. He recommended it for “speedy Relief and Permanent Cure of Consumption, Bronchitis, Asthma, Coughs, Colds, all Diseases of Lungs, Chest and Throat.” Marketed under the name of “Acacian Balsam” rather than “Aya-Pana…” or “Indian Hemp…” is significant since with the product name Brown uses to advertise his medicine to potential buyers refers to the Biblical Acacia– Acacia seyel or Acacia tortilis–his marketing ploy was designed specifically for inhabitants of the Bible belt including those who had recently moved to the West Coast.[36]

During the nineteenth century, religious overtones were commonplace in many medical writings. Therefore, an association of a Cannabis-based recipe with Acacia is not a surprise in view of the marketing techniques. Patent medicines were often marketed as “miraculous cures,” “Indian Remedies,” “South American bitter-cures”, “marvelous Chinese formulas,” and the like. In the Bible, the Acacian tree was known as “shittah” or “shittim” tree and was considered a holy tree. It was used to make Noah’s ark and its branches supplied wood for the Ark of the Tabernacle. Like other readily available Opium- and Coca-based patent medicines, marketing Cannabis was not as scrupulous and illegal a matter as it is today and in fact made up one of the many reasons for the miraculous effect of these mystery cures.

One of the most popular patent medicines of the nineteenth century to contained Cannabis was “Piso’s Cure for Consumption”, a remedy designed for patients suffering from tuberculosis and other lung conditions. A late nineteenth century formulary gives the following recipe for Piso’s Cure:[37]

Tincture of Tolu 1/2 ounce

Fluid Extract Lobelia 2 drachms

Fluid Ext. Cannabis Indica 2 drachms

Morphine Sulphate 4 grains

Tartar emetic 4 grains

Chloroform 1 drachm

Essence of Spearmint 10 drops

Hot Water 8 ounces

Sugar 14 ounces

The Chloroform in this recipe is a rather late addition to the patent medicine, and follows the successful use of Chloroform as an anesthetic. Thus Cannabis, along with Chloroform, Opium, and the Opium-derived Morphine Sulphate, make it readily apparent that this formula was intended to serve as a “nerve tonic” by treating the pain and agony associated with whatever ailed the patient at the time of its use. Other recipes found in the formularies containing Cannabis include a Chloroform-Morphine-Hydrocyanic Acid elixir, a Bromide-Henbane based formula (“Chloralida”), and “Fever Liniment” which included Opium, Camphor, Red Pepper, Aconite and Chloroform.[38]

Cannabis-based patent medicines also served as a treatment for seizures and were given in cases where the then-accepted Bromide remedy was ineffective. One Eclectic Medical Journal advertisement describes a patent medicine formula for a related product–“Bromidia. The Hypnotic.” The formula for this medicine was 15 grains Chloral Hydrate, 15 grains Bromide-Potassium, and one-eighth grain each of Henbane (Hyoscyamus niger) and Cannabis Indica extracts. This remedy reportedly cured or treated “sleeplessness, nervousness, neuralgia, headache, convulsions, colic, mania, epilepsy, irritability, etc.” The advertsier of this product, Battle & Company, Chemists’ Corporation, St. Louis adds: “In the restlessness and delirium of fevers it is absolutely invaluable.”[39]

Allopaths were not exempt from the patent medicine industry. Cannabis served not only as a general pain-reliever for treating aches and pains or for administration during surgery but also as a local anodyne. The use of Cannabis as such is seen in a “German Corn Cure” recipe, once administered quite often by allopaths:[40]

Salicylic Acid 8 ounces

Extract of Cannabis Indica 4 drachms

Collodion 24 ounces

Applied locally the salicylic acid helped this formula eat away at the corn while the Cannabis supposedly served as a local anesthetic.

In 1846, the allopaths formed their national association in Ohio, originally known as “the National Convention,” just two years after their chief competitors– the nationally-based American Institute of Homeopathy–was established, and just two years before the National Eclectic Medical Association was also formed in Cincinnati, Ohio. (The National Convention changed their name to “the American Medical Association” in 1847.) With its many medical and pharmacy schools, one of the first states to successfully to establish a state-wide (allopathic) medical association would be Ohio.

In its annual meeting of 1860, the allopath-based Ohio State Medical Society reported on the successful treatment of stomach pain, gonorrhea and chronic cough with Cannabis. That same year, an article of Cannabis sativa first appeared in the Proceedings of the American Pharmaceutical Association,[41] followed by another on Cannabis indica only two years later.[42] Soon, attention was drawn to the use of Cannabis as a medicine and testing its use became a priority to many members of the professional sphere. The first article on Cannabis resin appeared in 1863, followed by numerous publications in the Proceedings over the next thirty years; some of these articles concentrated on Cannabis sativa products (1871), physiological activity (1887), smoking Cannabis indica (1893), leaf histology (1897), Cannabis indica potency (1900), and Cannabis indica chemistry and causes for its deterioration (1902). Brief monographs on Cannabis indica were given for its use as a local anesthetic (1885) and for treating diarrhea (1888) and facial neuralgia (1890); few of the Cannabis articles were on Cannabis sativa. As a result of this gain in professional acceptance, numerous medical studies on Cannabis ensued for decades to come.[43]

The results of one interesting Cannabis study were published in 1881 in the Proceedings of the American Pharmaceutical Association. Due to its use as a smoking herb and the habit that was attached to Cannabis smoking, the absence or presence of Nicotine in Cannabis had been disputed for quite some time by professionals. In 1876, Preobraschenski published an article of Correspondenzen in the Berichte der Deutschen Chemischen Gesellschaft zu Berlin. In it he stated that according to his studies, Cannabis contained Nicotine.[44] This study and its claim has recently been repeated by an American chemotaxonomist in his key reference work.[45] Yet, when the presence of nicotine in Cannabis was tested for by the American Pharmaceutical Association in 1879/1880, no nicotia (nicotine) was found. Thus resulting article was published in the Proceedings announcing these negative findings.[46]

As a result of these studies and the related publications by the American Pharmaceutical Association, Cannabis extract was entered into the United States Pharmacopoeia (U.S.P.) in 1862 although not as an official drug. It was finally accepted as an official drug around 1870 in which year a monograph on it appeared in the United States Pharmacopoeia (U.S.P.) to be repeated in the 1880 revision. Cannabis remained as an entry in the pharmacopoeias from 1873 to 1942.[47] In some publications, Cannabis would later be removed from the list of official botanical medicines due to difficulties experienced in establishing methods to standardize the resin levels and remove the impurities from its preparations.

A historically relevent item to note regarding Cannabis use relates to the esteemed neurologist Dr. Charles-Edouard Brown-Sequard. Dr. Brown-Sequard served as a neurologist in the New York City Medical School during the nineteenth century. He was highly respected for his work in which he studied the human nervous system and how the nerves were interconnected throughout the spinal cord and human body. One of his studies concentrated on the conduction of signals along the nerve through the spinal column and to the brain, for example pain nerves. In the limelight of other nineteenth century neurophysiologists and doctors, he developed a formula for a medicine which he precribed to many of his patients at the New York medical school–“Brown-Sequard’s Neuralgia Pills”–consisting of:[48]

“Extract Hyoscyamus 67 grains

Extract Conium 100 grains

Extract Opium 50 grains

Extract Aconite 33 grains

Extract Cannabis Indica 25 grains

Extract Stramonium 20 grains

Extract Belladonna 16 grains

Make into 100 pills. Dose, one pill.”

Employing the neurotoxic resin of Cannabis along with alkaloids of Hyoscyamus (Henbane), Stramonium (Jimsonweed/ Locoweed), Belladonna, Opium, Aconite, and Conium (Hemlock–an excitant/convulsant), Brown-Sequard produced a formula with a high degree of effectiveness as a drug for the nervous system. Therefore it is not surprising that this remained one of his favorite hospital formulas throughout his years of practice as a neurologist.

As a result of its acceptance by many allopathic and non-allopathic practitioners, Cannabis was entered into the Fifth Revision of the United States Pharmacopoiea in 1860; two recipes were published. A decade later, the 1870 Revision would contain five more recipes of Cannabis. Finally, in 1880 four Cannabis-entries were to be accepted and repeatedly published by the Pharmacopoeia until their exclusion in 1940:[49]

1. Cannabis Indica. Indian Cannabis.

2. Extractum Cannabis Indicae. Extract of Indian Cannabis.

3. Fluidextractum Cannabis Indicae. Fluidextract of Indian Cannabis.

4. Tincturae Cannabis Indicae. Tincture of Indian Cannabis.

Despite its omission from the Pharmacopoeias, Cannabis remained in Dispensatories and Hospital Formularies for decades to come. Thus it can be found in many of the listings of herbal medicines distributed by many major pharmaceutical companies of the nineteenth and early twentieth centuries. Some of these include:

Parke-Davis, 1893. Indian Cannabis (Cannabis indica)

Eli Lilly & Company. Cannabis Indica.

Squibb’s Materia Medica, 1906. Cannabis Indica, Squibb

E.R. Squibb & Sons. 1919. American Cannabis.

Extractum Cannabis; Dose, 0.01 Gm. (1/6 grain)

Fluidextractum Cannabis; Dose, 0.1 mol (1 1/2 min.)

Tinctura Cannabis; Dose, 0.75 mil (12 min.)

In more recent years, Cannabis has once again come to serve an important role in allopathic medicine and remains in use by the many different forms of alternative medicine currently be practiced. Homeopathy, Naturopathy, Ayurvedics, Oriental medicine, Japanese medicine, and to a lesser degree allopathy make use of Cannabis-based formulas although for greatly different reasons based on each one’s unique philosophy for health care and the methods to employ for promoting good health and vitality.

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Section 6. Conclusion

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Since the first writings on the use of Cannabis as a medicine, it has had a long history of use health care and nutrition. This changed when alternative medicines were up against allopaths during the nineteenth century. The resulting political downfall of alternative medicine, in particular electrotherapy, diet therapy, homeopathy, physiomedicine, eclectics, and naturopathy. This has since led in part to the downfall of the related use of the certain herbal and patent medicine as well. The final downfall of herbal therapy came when herbal preparations could be replaced by patentable chemicals or formulas in the mid 1900s. This was about the same time that test tube-manufactured drugs such as Penicillin and the early cancer-drugs were discovered. Since then, Cannabis has on-and-off been accepted as a valid herbal, naturopathic or allopathic medicine. Being botanical in origin, Cannabis itself cannot be patented by drugs companies due to laws disallowing the patenting of general plants or plant substances (although certain formulas and products containing Cannabis can be patented.) Still, plant products can be manipulated, changed and remarketed by the producers either as patented clones of hybrids or a chemical alteration of their drug-products. As a result, the use of Cannabis as an herb in making prescriptional formulas is limited to only a few recipes which are on occasion accepted by the Food and Drug Administration as official remedies, i.e. for the treatment of Glaucoma and post-chemotherapeutic nausea. Such acceptance remains in a constant state of flux resulting in limitations placed upon herbal medicine and the use of Cannabis as a medicine.

Most of these citations came from Proceedings of the American Pharmaceutical Association. Index 1851-1902. Proceedings for 1861 were not published. For volume number subtract ’50’ (years) from the year of publication for 1851-1860, thereafter subtract ’51’.